I am a physician with long-standing interests in health policy, medical ethics and free-market economics. I am the co-founder of Freedom and Individual Rights in Medicine (FIRM). I graduated from University of Michigan Medical School and completed my residency in diagnostic radiology at the Washington University School of Medicine in St. Louis (where I was also a faculty member). I'm now in private practice in the Denver area. All my opinions are my own, and not necessarily shared by my employer.

Why Doctors Should Not Ask Their Patients About Guns

Should doctors ask patients if they own guns? Currently, ObamaCare bans the federal government from using patient medical records to compile a list of gun owners. But following the Newtown, CT shootings, President Obama issued an executive order clarifying that “the Affordable Care Act [ObamaCare] does not prohibit doctors asking their patients about guns in their homes.” The American Academy of Pediatrics (AAP) similarly encourages physicians to ask patients if they own firearms — in the name of protecting child safety. As a physician, I consider this advice misguided. Instead, physicians should not routinely ask patients whether they own guns, because it could compromise the integrity of the doctor-patient relationship.

First, the American Academy of Pediatrics is not politically neutral in the gun debate. The AAP supports standard Left positions, including “federal firearms legislation that bans assault weapon sales and the sales of high capacity magazines” and “the strongest possible regulations of handguns for civilian use.” The AAP also recommends that parents “NEVER have a gun in the home” (“NEVER” capitalized in their statement). Their website also cites the now-discredited 1986 claim that, “A gun kept in the home is 43 times more likely to kill someone known to the family than to kill someone in self-defense.”

However, numerous scholars have noted that most of those unfortunate deaths were suicides that would have likely still occurred even if no gun had been available. David Kopel of the Independence Institute observed that after excluding such suicides, the ratio was closer to 2-to-1. Furthermore, comparing numbers of accidental or unlawful deaths to justified deaths of criminals is misleading, because it fails to include many nonlethal self-defense uses of firearms. Depending on the source, there are 800,000 to 2.5 million defensive gun uses each year where law-abiding gun owners deter criminals without firing a shot (let alone killing the bad guy).

As Kopel noted, we don’t measure the efficacy of the police by the number of criminals killed, but by how well they stop crime. Similarly, the value of civilian-owned guns should not be measured by the number of dead intruders, but rather by crimes prevented and lives saved. The flawed 43-to-1 statistic vastly underestimates the lifesaving value of guns for law-abiding homeowners.

Yet the AAP does not tell parents to “NEVER bring your child to a swimming pool,” nor does it advocate “the strongest possible regulations of swimming pool ownership.” Rather, it recommends that parents supervise children around swimming pools and follow basic rules of water safety. The AAP correctly recognizes that a home swimming pool can be a genuine value to a family, provided that parents and children follow proper precautions. Similarly, a gun can be a genuine value to responsible homeowners, provided that parents and children follow proper precautions. With both swimming pools and firearms, homeowners should determine for themselves whether the benefits outweigh the risks for their particular circumstances.

The AAP also supports teaching children how to swim, whether or not they have a pool at home. This is just common sense. Children might encounter swimming pools when visiting friends or neighbors. Similarly, doctors should recommend that children learn basic principles of firearms safety appropriate for their age, whether or not their parents own a gun, because children may still encounter firearms at neighbors’ or relatives’ houses. Parents interested in learning more on this should visit websites like GunProof.org.

Furthermore, law-abiding gun owners will likely view being asked about guns as an unwarranted intrusion on their privacy. No Congressman is proposing anti-swimming pool legislation, whereas powerful political forces are seeking to curtail Americans’ gun rights. Although the law does not yet allow the government to harvest gun ownership information from medical records, many gun owners are concerned such information may not remain private. The Washington Post reported that gun control groups are already lobbying to allow compilation of gun ownership data from medical records for research purposes. Plus, electronic medical records are already valuable targets for malicious hackers. Many gun owners fear becoming targets if their information falls into the wrong hands, just as some legal gun owners were apparently targeted for burglary after a suburban New York City newspaper recently published their names and addresses seeking to “out” them.

Doctors already have a professional and legal responsibility to notify the authorities if they believe patients pose an imminent threat to others or themselves. But routine inquiry about gun ownership goes far beyond this obligation. Such inquiries will instead only offend and alienate many responsible gun owners, compromising the trust essential to the doctor-patient relationship. Doctors should not put themselves in a position where patients view them as willing (or unwitting) agents of the government working against their interests.

The law should neither prohibit nor mandate that physicians ask about guns. Both would violate doctors’ rights to free speech. Hence, I disagreed with the now-overturned Florida law that had prohibited physicians from asking patients about gun ownership. But as matter of good professional practice, doctors should not routinely ask. And if doctors work for hospital systems that ask this question, they should defend and support their patients who decline to answer.

A local colleague, Dr. Matthew Bowdish, has declared, “I will not undermine the Second or Fourth Amendment rights of any of my patients who are lawful gun owners. Nor will I record my patients’ gun ownership status in any medical records that could be accessed by government officials unless relevant to a specific medical issue.” This should be the credo of all freedom-loving physicians.

Paul Hsieh, MD, is a physician and co-founder of Freedom and Individual Rights in Medicine (FIRM). He practices in the Denver area.

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